AB1491 ACUTE EFFECTS OF AN INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUE ON CHRONIC NECK PAIN: A DOUBLE-BLIND, RANDOMIZED CONTROLLED TRIAL
Authors: H. Gerçek, B. S. Unuvar, O. Umit Yemisci, A. Aytar
Journal: Annals of the Rheumatic Diseases (2022)

Background Individuals with chronic neck pain, proprioceptive afferent information from the cervical spine may be impaired due to the presence of pain. Instrument-assisted soft-tissue mobilization (IASTM) is used to reduce pain and improve range of motion (ROM) and function. Cervical sensorimotor control includes the central integration and processing of all afferent information and the execution of the motor program through the cervical muscles and contributes to the maintenance of head posture and balance(1). In individuals with chronic neck pain, proprioceptive afferent information from the cervical spine may be impaired due to the presence of this pain(2). Many treatment modalities such as instrument-assisted soft-tissue mobilization (IASTM) have been used to reduce pain and increase proprioception(3). IASTM is used to reduce pain, increase soft-tissue mobility, and improve range of motion (ROM) and function. These instruments cause microtrauma to restore normal elasticity and function in soft-tissue(4). Kivlan has shown that significant and rapid changes in muscle function can occur with only a single IASTM application and have suggested the following mechanisms of action: an increased fascial motility, a proliferation of extracellular matrix fibroblasts, and an increased blood flow to the area close to the injured tissue, with decreased cellular matrix adhesion and localized ischemia(5). Objectives Aim of this study, to determine the acute effects of single-session, IASTM on cervical joint position error (JPE) and pain in individuals with chronic neck pain. Methods A total of 39 individuals (mean age=40.18±11.10 years) with chronic neck pain were included in this study. We divided the participants into IASTM, sham, and control groups of 13 members each. In the IASTM group, intervention was applied to the sternocleidomastoid and trapezius muscles with an application time of 45 seconds and a frequency of 60 beats/min. In the sham group, IASTM was applied at a 90° angle without pressure. The control group received no intervention. The pain severity and joint position error were evaluated before and after the intervention, by using the visual analog scale (VAS) and a cervical range of motion device. Results The effects of time and treatment group on VAS score were statistically significant. The effect of time and treatment for VAS score was statistically significant (p=0.001). When the post-test was examined according to application, a statistically significant difference found in VAS scores (p=0.001), with the lowest pain score in the IASTM group and the highest pain score in the control group. The significant improvements found in JPE in all aspects of the cervical region in the IASTM group (p&lt;0.05). In the sham group, significant improvements observed in cervical extension, left rotation, and left lateral flexion movements in JPE (p&lt;0.05). Conclusion Single-session IASTM is effective for improving the acute pain and JPE in individuals with chronic neck pain. References [1]Michiels S, De Hertogh W, Truijen S, November D, Wuyts F, Van de Heyning P. The assessment of cervical sensory motor control: A systematic review focusing on measuring methods and their clinimetric characteristics. Gait Posture. 2013;38(1):1–7. [2]Uremović M, Cvijetić S, Pasić MB, Serić V, Vidrih B, Demarin V. Impairment of proprioception after whiplash injury. Coll Antropol. 2007;31(3):823–7. [3]Damgaard P, Bartels EM, Ris I, Christensen R, Juul-Kristensen B. Evidence of Physiotherapy Interventions for Patients with Chronic Neck Pain: A Systematic Review of Randomised Controlled Trials. ISRN Pain. 2013;1–23. [4.]Baker RT, Nasypany A, Seegmiller JG, Baker JG. Instrument-Assisted Soft Tissue Mobilization Treatment for Tissue Extensibility Dysfunction. Int J Athl Ther Train. 2013;18(5):16–21. [5]Kivlan BR, Carcia CR, Clemente FR, Phelps AL, Martin RL. The effect of Astym Therapy on muscle strength: a blinded, randomized, clinically controlled trial. BMC Musculoskelet Disord. 2015;16(1):325. Disclosure of Interests None declared